To Help the Homeless, San Diego Needs Data Coordination

Siloed information is making it more difficult to get assistance to those in need – in spite of relatively new computer system.

by John Wilkens, The San Diego Union-Tribune
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November 13, 2017

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(TNS) –– Three years ago, at a news conference outside a downtown San Diego shelter, local officials celebrated a turning point in the fight against homelessness.

They announced that computer upgrades would integrate dozens of local service agencies into one software program, enabling them to share information and coordinate care.

“We will never miss an opportunity to connect a homeless individual or family with an open emergency bed or a housing unit,” said Mayor Kevin Faulconer. “We’re using the power of technology to make real change in people’s lives.”

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Until about a month ago, agencies that logged into the Homeless Management Information System (HMIS) could access only their own records, not data from other providers.

They wouldn’t know if someone they were trying to help — many of them suffering from mental illness or substance abuse and not the most reliable of self-reporters — already had a case manager at a different facility.

They wouldn’t know what services had worked for that person somewhere else, and which ones hadn’t.

It was, in computer parlance, a closed system. And it wasn’t very efficient.

“You want the left hand to know what the right hand is doing,” said San Diego City Council member Chris Ward, vice-chair of the board of directors for the Regional Task Force on the Homeless, which oversees the computer system.

It was kept closed in large part because of client-confidentiality laws. Policies had to be put in place to safeguard the information as it is passed around, and all the agencies had to agree to follow them. Clients had to sign release forms. Bugs in the software had to be worked out.

To share information, the various agencies also had to move beyond protecting their own “data silos,” built up over the years as they competed with each other for the now-almost $20 million in federal funding the region gets annually to combat homelessness.

“Our community needs to do a better job of thinking about what’s best for the system as a whole,” said Julie DeDe, director of community relations at Father Joe’s Villages, one of the leading local providers of homeless services.

“At the end of the day,” she added, “that’s what it’s about: providing better services for the people who need help.”

Crunching the numbers

The effort to collect and use data to track homeless services in San Diego dates to at least 2009, when the federal government passed a law requiring communities to develop a system that would better match those in need with available resources.

Here’s how what’s known as the Coordinated Entry System is supposed to work:

A homeless person who wants to get into long-term housing is required to undergo an assessment. All the agencies use the same form, so in theory the person should only have to be assessed once. The assessment yields a “level of need” score that is used to determine who should get priority for housing, and what kind. The information is put into the HMIS.

Housing providers also enter information into the computer about what they have available and what their criteria are for admission. Some cater to veterans. Some are for families, or only for single men.

Then the person is matched with the place.

Of course, it’s never as simple in practice as it is on paper. Just because someone qualifies for a certain kind of housing doesn’t mean a unit will be available. And sometimes when a unit opens up, the person best suited for it can’t be found. They don’t all have cellphones. They don’t leave forwarding addresses. They’re homeless.

But it’s still a big improvement over the old days, when a homeless person had to get a list of local providers and contact them one-by-one to find a slot.

“That’s a monumental burden on a client, especially someone who is disabled or doesn’t have transportation and can’t get around to all the different places,” DeDe said.

The new system is only as good as the data that’s entered, and there have been some issues with consistency across the various providers, but for many users, what’s emerging is a fuller picture of the battle against homelessness and whether it’s working.

According to records compiled by the Regional Task Force, during the fiscal year that ended Sept. 30, 13,099 homeless people entered the “system of care” here for the first time in the past five years. That includes people who went through the formal “level of need” assessment for long-term housing, those who went to day centers or were contacted by outreach teams, and those who went into emergency shelters and interim housing.

Almost half of them entered the system having stayed previously in a place “not meant for habitation,” meaning, basically, the street. Almost 20 percent had been living with family or friends. (The rest were in different kinds of housing.)

During that same period, a similar number of clients, 13,166, exited the care system. About 42 percent of them went into permanent housing. Almost 21 percent went into institutions (hospitals, jails, substance-abuse facilities) or temporary housing (hotel, foster care, with family or friends). And 20 percent wound up on the street again.

Holes in the system

San Diego is moving toward a “housing first” approach to homelessness that gets people into apartments quickly and then tries to correct the factors — no job or income, substance abuse, mental illness — that put them on the street in the first place.

It’s a method backed by various studies and the experience in cities like Salt Lake City and Houston, and projects aimed in that direction get priority in federal funding.

That’s why for many providers here the number they watch most closely in the local database is the one showing how many homeless in San Diego are in need of permanent housing. Right now that’s 8,648.

According to the most recent Annual Homeless Assessment Report filed with Congress, the city of San Diego — where most of the region’s homeless congregate — has only about 2,500 beds in the database available for permanent housing, and they’re full. More are being built or planned, and officials are ramping up efforts encouraging local landlords to accept subsidized homeless tenants.

There’s also discussion about how to plug another hole in the care system. People who need emergency shelter are often told to call 211, the non-profit phone line launched a dozen years ago. But those who call expecting it to be a kind of Priceline.com, with an immediate match to an available bed, wind up disappointed. There’s nothing in the database that shows real-time availability of shelter beds.

It’s not known how many callers then just give up and pitch a tent in Balboa Park. The 211 operators have information about the various programs available — type of clientele served, criteria for admission — and they ask questions of callers aimed at directing them to the most suitable place. But finding a bed that night? They’re pretty much on their own.

Ward, the San Diego city council member, said he sees the ongoing efforts to improve the database as part of a continuum that’s accelerated in recent months amid a hepatitis A outbreak that has killed 20 people and infected more than 540, many of them homeless.

There’s a political will now to own the problem and solve it, he said, and “making sure our data system is not just developed correctly but used correctly is the next step to showing success.”